肾移植术后尿路上皮癌发病特点的文献统计分析

目的 统计分析国内肾移植尿路上皮癌患者的发病率、发病特点，提高临床工作中对此类疾病的认识。方法 检索目前从2005~2017年的国内权威中文数据库中国知网全文数据库和万方全文数据库，分别按照发病率、发病年龄、性别、发病部位、发病时间、马兜铃酸肾病的影响等方面收集统计数据，分析其临床意义。结果 文献统计肾移植术后尿路上皮癌的发病率约1.17~2.27%，高于普通人群中的发病率；发病年龄45~56岁；女性发病率64.93%，高于男性35.07%，差异有统计学意义（P＜0.05）；原上尿路发病率50.81%，高于膀胱49.19%，，移植肾同侧发病率70.80%，高于对侧为29.20%，差异无统计学意义（P＞0.05）；发病时间的分布主要在肾移植术后1~16.8个月内；相应文献报道马兜铃酸肾病是肾移植术后尿路上皮癌发病和复发的危险因素。结论 具有马兜铃酸肾病病史的女性患者是肾移植术后尿路上皮癌发生的高危人群，对高危患者的诊断和治疗应该更加重视，改进治疗方案，做到早发现早治疗。

Literature and Statistical Analysis of the Characteristics of Urothelial Carcinoma after Renal Transplantation

Abstract:Objective To analyze the incidence and characteristics of urothelial carcinoma in patients with renal transplantation and to improve the understanding of such diseases in clinical work.Methods This paper retrieves the full text database of Chinese knowledge network and the full text database of Chinese authoritative Chinese database from 2005~2017,and collect statistical data according to the incidence,age,sex,location,time of onset,the influence of aristolochic acid nephropathy and so on,and analyze its clinical significance.Results The incidence of urothelial carcinoma after renal transplantation is about 1.17~2.27%,which is higher than that in the general population;the age of onset is 45~56 years old;the incidence rate of female is 64.93%,which is higher than that of male 35.07%,the difference was statistically significant(P<0.05);the incidence of the original upper urinary tract was 50.81%, which was higher than that of the bladder 49.19%,and the incidence rate of ipsilateral transplantation was 70.80%,which was higher than that of the contralateral side 29.20%,the difference was not statistically significant(P>0.05);the distribution of onset time was mainly within 1~16.8 months after renal transplantation;the corresponding literature reported that aristolochic acid nephropathy is a risk factor for the onset and recurrence of urothelial carcinoma after renal transplantation.Conclusion Female patients with a history of aristolochic acid nephropathy are at high risk of urothelial carcinoma after renal transplantation.The diagnosis and treatment of high-risk patients should be paid more attention to,and the treatment plan should be improved to achieve early detection and early treatment.